December 2019

American Nations: A History of the Eleven Rival Regional Cultures of North America, by Colin Woodard. 2011.

Thoughts / Questions

• Impact of (1) religion, and (2) experience of war/oppression on culture of ethnoregional populations
• Importance of ability to expand to maintain dominance of a nation – eclipse of Tidewater; New Netherlands
• Why was New France not more successful at expansion and dominance?
• Environment trumps ethnoregionalism in establishment of Far West
• How does this analysis apply to the upcoming presidential contest?
• The book leaves me of two minds: one the one hand, it strikes me that the existence of the US as it is today is the result of many low probability events; on the other hand, it leaves me feeling that the US is more robust than it may seem – e.g., a lot of awful people, events and processes have not ‘destroyed’ the country or culture. Andrew Jackson and Woodrow Wilson seem no worse than Trump
• It is striking that sometimes individuals can make all the difference: William Penn, and Samuel de Champlain.
• Impact of policies: Spanish colonial policies on El Norte; internal colonization policies on Far West.
• Impact of the Netherlands on US history and institutions

C1: Founding El Norte

“Colonial El Norte was the neglected, far flung borderland of a distant, collapsing empire, and would remain so for a quarter of a millennium.” The settlements in El Norte were isolated from one another, by design, with trade between them prohibited by Spain, and discouraged by vast distances.

The main driver of the colonization was the Spanish empire’s religious mission, and it spread by the establishment of self-sufficient missions with religious and military personnel which indoctrinated local populations and turned them into feudally governed workforces. Because the Spanish empire was failing and had few resources to spare, and because of the inefficiency of the colonization approach, “the communities tended not to grow as malnutrition, smallpox and syphilis kept mortality high and childbirths low.”

Most Hispanics came to the new world because they were told to. There was no self government, with religious and military leaders holding power; in the few towns authority came to be held by a self perpetuating oligarchy of the wealthiest citizens. Ordinary people were expected to give their loyalty to their local patron, who provided employment, welfare, and sponsored religious activities. Most Spanish colonists were male, and as a consequence took native wives. By the early 1700’s, the majority of the population of Mexico and El Norte was mestizo, and thus the caste system that shaped society in Spain had little impact in El Norte.

The open range cattle industry originated in El Norte and was based on Spanish precedents, as was the use of mounted vaqueros to round up, herd, brand and drive large numbers of cattle on open range. It was the Franciscan’s who introduced cowboy culture (in contravention to Spanish laws prohibiting Indians from riding horses), because tallow and hides were one of the few products they could profitably produce for export.

“By spearheading the effort to snuff out the Protestant Reformation, the Spanish had earned the lasting hatred of the English, Scots and Dutch, who regarded them as the decadent unthinking tools of the Vatican’s conspiracy to enslave the world. This virulent anti-Spanish feeling became deeply engrained in the cultures of Yankeedom, Appalachia, Tidewater and the deep South.”

C2: Founding New France

A French expedition landed in eastern Maine in 1604, and founded a colony on an island in the St Croix. It was led by a French noble, Pierre Dugua, the sieur de Mons, and a commoner, Samuel de Champlain, thought to be the illegitimate son of the French King. They both had radical, if somewhat different visions, for New France. de Mons envisioned a feudal society, but one which allowed commoners to hunt, fish, practice their own religions, and be upwardly mobile. Champlain shared the vision of a feudal society, but also believed it should coexist in a friendly, respectful alliance with Native American nations. “They would intentionally settle near the Indians, learn their customs, and establish alliances and trade based on honesty, fair dealing, and mutual respect.” Champlain wanted to bring Christianity and other aspects of French civilization to Native Americans, but wanted to accomplish this by persuasion and example; he also thought inter-marriage was not only tolerable but desirable.

When the colony was founded, it had a rough first winter but was saved by food provided by the Native Americans. The French ‘gentlemen’ tended to ignore the French commoners, but treated the Indians as equals and invited them to feasts and plays, and in turn were invited to Indian events, and learned Native American languages and practices such as making canoes and snowshoeing. This pattern was repeated in 1608, when Champlain founded Quebec. Furthermore, he sent young men to live with the Indians to learn their languages and practices, and the Indians reciprocated. Other Frenchmen repeated this pattern, due to the shortage of female colonists. Eventually, “New France became as much an aboriginal society as a French one and would eventually help pass this quality on to Canada itself.”

In 1663 the French King attempted to establish a more feudal society in New France, by sending large number of impoverished people to work as indentured servants. However, few accepted their assigned roles as peasants once their indentures were completed, and instead fled the fields to live in the woods. “But the end of the seventeenth century, roughly one-third of indentured servants had taken to the forests and increasing numbers of well-bred men were following them.”

Chapter 3: Founding Tidewater

Jamestown was founded in 1607, and was a disastrous effort. It was manned by a mix of gentlemen adventurers and forcibly deported indigents, none of whom were knowledgeable about or inclined to farm. They expected to succeed in the way that the Spanish had – accreting worshipful natives to do their bidding — but instead arrived in the midst of a strong confederation of 20 tribes and 24,000 people ruled by chief Powhatan. The confederation resisted extortion by the colonists, although it was eventually overcome by wave upon wave of colonists, attracted by the profitable enterprise of tobacco plantations (and fueled by the aristocrats on the losing side of the English Civil War).

The Tobacco plantations required a lot of labor provided by indentured workers; the conditions were terrible, with a mortality rate of up to 30% a year. Those who survived indenture received land, tools and freedom – and while most were white there were some of African descent (perhaps by way of New Amsterdam), the interesting point being that Virginia did not start out as a racially-based slave society.

The goal of the elites in Virginia and Maryland was to re-create the genteel manor life of rural England – and by the early 17^th Century they had largely succeeded in creating a pastoral landscape with manors and a hereditary elite that controlled all aspects of society. It became increasingly difficult for the gentry to recruit commoners to work their land, and so they turned to the form of slavery recently introduced into the deep south from the Caribbean colonies. There were no towns other the Jamestown and St Mary’s City until the end of the 17^th Century, and even these remained villages of a few hundred for a long time.

Chapter 4: Founding Yankeedom

The dominant colonies of New England were founded by Puritans intent on creating a religious utopia based on the teachings of John Calvin. Nearly half of Yankeedom’s early settlers came from East Anglica, the most economically sophisticated part of Britain, and a region profoundly influenced by the Netherlands, which lay just across the English channel.

In particular, during the 1630’s, 25,000 Puritans migrated from Britain due to their unwillingness to compromise. The Puritan emigres were led not by noblemen but by an elite distinguished by their education. They were opposed to aristocracy and the conspicuous display of wealth and its leaders did not hand out massive swaths of land; instead they gave town charters to approved groups of settlers who in turn elected a committee of their peers to govern matters. Puritans believed in self-government, and every town was to be a little republic unto itself. Because of the Puritan belief in divine revelation through reading the scriptures, everyone had to be literate, and thus public schools were built and staffed as part of the establishment of any town.

Puritans saw themselves as having a mission to convert others; they were fearful of otherness, in particular the Native Americans, who they saw a savages to whom normal moral obligations – like respect of treaties, fair dealing, etc – were not due. “For four decades, Boston ruled the region as the capital of the United Colonies of New England…” and it attempted Yankee coups in Maryland and the Bahamas, annexed the Royalist colony of Maine, and reduced Conneticut, Plymouth and New Hampshire to satellites. Only Rhode Island was exempt.

Chapter 6: Founding New Netherland

New Netherland, as such, lasted from 1624 to 1664 when it was conquered by the English; at that time it extended only to Wall street, and had about 1,500 inhabitants. It was established as a fur trading post, and governed for the first few decades by the Dutch West India Company. In 1643 a Jesuit estimated its population at 500, and the number of languages spoken at 18.

The Dutch were unique among 17^th Century Europeans in being committed to free enquiry, freedom of the press, and religious pluralism; it was a haven for persecuted people across Europe. As a free and prosperous country, the Netherlands lacked a stock of people desperate to emigrate. The Dutch tolerated diversity rather than celebrating it; “the Dutch people … had internalized the lessons of Europe’s horrific (and going) religious wars, in which many of their countrymen had perished.”

In 1664 New Amsterdam was taken by surprise by the arrival of a hostile English fleet.

“During a tense standoff, the Dutch negotiated an unusual surrender agreement to ensure the survival of Dutch norms and values. New Netherlanders would keep their business and inheritance laws, property, churches, language, and even their local officials. They could continue trade with the Netherlands, Making New Amsterdam the only city in the world with simultaneous ties to both major trading empires. Most important, religious toleration was ensured.”

Chapter 6: The Colonies’ First Revolt

The English controlled colonies first rebelled in the 1680’s, not as a coalition, but in a series of separate rebellions by Yankeedom, Tidewater and New Netherlands. This was due to the ascension of James II, who wanted to impose discipline and political conformity on the colonies by dissolving representative assemblies, imposing high taxes, and installing military authorities as governors; he also had converted to Catholicism and appointed a number of Catholics to high posts. This also stimulated resistance to James II in Britain – there were two revolts that were put down, but the third involved inviting William of Orange, military leader of the Netherlands, to invade. William of Orange succeeded in replacing James, but although the North American rebellions had succeeded, he did not roll back all of the changes introduced by James II. In particular, he did not restore New Netherlands to the Netherlands.

It was during this period that Maryland, which was largely ruled by Catholics, was transformed into something closely resembling Virginia, with Protestants/Anglicans in the ascendency.

Chapter 7: Founding the Deep South

“From the outset, Deep Southern culture was based on radical disparities in wealth and power, with a tiny elite commanding total obedience and enforcing it with state-sponsored terror. Its expansion ambitions would put it on a collision course with its Yankee rivals, triggering military, social, and political conflicts that continue to plague the United States to this day.”

The founding fathers of the Deep South were the younger sons and grandsons of the founders of the Barbados colonies, which had a horrific slavery system; they introduced chattel slavery to the English-speaking world, and also adopted the gang labor system from South America, wherein slaves were worked to death. As younger sons, the founders were very concerned with maintaining the trappings of aristocracy and the notion that they belonged to a privileged class – this included embracing the Anglican church.

While both the Deep South and Tidewater practiced full-blown slavery, Tidewater had a far lower proportion of slaves – 1 to 1.7 whites – rather the the Deep South’s 5 to 1 ratio. Tidewater also was home to blacks who were not slaves, and until the end of the 17^th Century, in Tidewater a person’s position was defined by class rather than race. In contrast, the Deep South had a caste system; the Deep South also, due to the larger number of slaves and higher mortality rate, imported slaves from many countries, and mixed them together, producing a melting pot of African cultures and languages.

Georgia did not start out as part of the Deep South, but rather as a utopian experiment in which poor were given their own farms, with the expectation that work and ownership would cure them of their alleged laziness. However, the paupers were eager to buy slaves, and in 1740’s and 1750’s, South Carolinans seized control of Georgia’s government and ensured the best land was granted to them and their friends, and that a Barbadian style slave code was adopted.

Chapter 8: Founding the Midlands

“From its inception in the 1680’s, the Midlands was a tolerant, multicultural, multilingual civilization populated by families of modest means – many of them religious – who desired mostly that their government and leaders leave them in peace.”

The Midlands was the result of a social experiment by William Penn, son of Admiral William Penn, who received a grant of the 45,000 square miles that made up Pennsylvania as a payoff of debts owed to the admiral by Charles II. Penn envisioned a country where people of different creeds and ethnic backgrounds could live together in harmony and that extended the vote to almost everyone; Penn also envisioned a pacifist government that respected native americans and paid them for land taken. Penn was very well organized, and distributed information about the new colony across England, Ireland, the Netherlands and large swaths of Germany. By 1686 an initial wave of immigration (mostly Quakers?) had resulted in 8,000 people in Pennsylvania.

A second wave of immigration consisted largely of German peasants who were refugees from the Palatine, a war torn area of Germany. They were Protestants, and arrived in large extended families or even as entire villages: 5,000 arrived from 1683-1726, and 57,000 by 1755. Some were Amish, Mennonites and Brethren of Christ; thousands more were mainstream Lutherans and German Calvinists. Penn let them settle their own communities where they could maintain their ethnic identity and religious customs. The Germans adapted to Quaker plans for the new society; they were mainly interested in farming, and endorsed Quaker policies and government. The social plan was a great success; Quaker government, however, was a disaster, due to a lack of interest in governing, doctrinal quarreling, and pacifism in the face of external aggression.

From 1717-1775 over a 100,000 Borderlanders from Scotland and Ireland arrived in Pennsylvania, most going straight to the hilly frontier in central Pennsylvania. The Borderlanders were not in sync with Quaker ideals, and occupied Indian lands without paying for them, pushing tribes into alliance with New France who provided them with weapons. This lead to massacres and armed conflict, which the pacifistic Quakers refused to respond; as a result the Quakers lost control of the government, with Ben Franklin – arrived from Yankeedom – and his allies dominating the political scene for the moment. Also, during this period, Yankees from Conneticut were spreading across northern Pennsylvania and the Wyoming valley.

Chapter 9: Founding Greater Appalachia

The Borderlanders came from the war-torn borderlands of northern Britain — lowland Scotland, northern England, and the Scots-Irish controlled north of Ireland – where they had weathered 800 years of nearly constant warfare. Under such conditions Borderlanders learned to rely only on themselves and their extended families; they were suspicious of any kind of outside authority, and valued individual liberty and honor above all else.

“Life in Britain had taught them not to invest too much time and wealth in fixed property, which was easily destroyed in time of war. Instead, they stored their wealth in a very mobile form: herds of pigs, cattle, and sheep. When they did need cash, they distilled corn into a more portable, storable and valuable product: whiskey… This was a lifestyle that allowed for long periods of leisure… Justice was meted out not by courts but by the aggrieved individuals and their kin via personal retaliation. … [Internal] Dissent or disagreement – whether by neighbors, wives, children or political opponents – was unacceptable and often crushed savagely. … Borderlanders tolerated enormous inequalities within their communities.”

The elite were usually the charismatic heads of “good families,” a tenth of the population who controlled most of the land; the bottom half had no land at all, and survived as tenants of squatters.

In Pennsylvania, Borderlander behavior lead to conflicts with the Indians – the authorities had encouraged them to go the frontier where they might form a buffer between native Americans and the more docile settlers — and in 1763 a conflict led to the formation of a Borderlander army of 1,500 that marched on Philadelphia intending to murder more peaceful Native Americans who had fled there. Benjamin Franklin saved the day, negotiating with the Borderlanders, whose chief demand was proper representation in the provincial assembly (Midlanders had twice as many representatives per capita).

Elsewhere the Borderlanders had spread down the Appalachian mountains, and as their society became codified, the have-nots turned to crime and gangs to support themselves. In response, the elite organized vigilante gangs – most prominently the Regulators – to hunt down outlaws from Georgia to Virginia. They also drove of sherrifs and judges sent by the regional governments, and demanded proportional representation in the various state legislatures.

At various times, Borderlanders tried to form their own governing entities: the Fair Play territory in Pennsylvania (50 families, for 5 years); the state of Transylvannia in eastern Tennessee and central Kentucky(1775).

Parts 2 & 3

The second part of the book describes the interactions among the nations in the American revolution, emphasizing that the revolution was by no means unanimous, and that some were mostly neutral (Midlanders), and some were divided (Borderlanders), and some mostly loyalists (Tidewater; Deep South), depending on where they thought their interests lay.

The third part of the book discussed the spread of four nations – Yankeedom, the Midlands, Appalachia, and the Deep South – to the west, and the conquest of El Norte and founding of the Left Coast.

Chapter 20: Founding the Left Coast

The majority of the Left Coast’s early immigrants were Yankees, hoping to found another New England; they didn’t wholly succeed, but did imprint the stamp of utopian idealism. Early on New Englanders (along with New France) had the best understanding of West Coast conditions due to their long distance ship-borne fur trade. Various missionaries from Yankeedom organized settlement expeditions, driven in part by fear of Catholicism. Although the Yankees created a provisional government in the Oregon Territory in 1843, within a few months an expedition of Borderlanders arrived, doubling the population of the Williamette Valley. As time went on, Borderlanders came to outnumber Yankees 15 to 1, but the Yankees settled in towns and controlled civic institutions, whereas Borderlanders developed farms in the countryside. Yankees also settled in southern California, where they blended with El Norte culture.

“In what was one of the largest spontaneous migrations in human history to that point, 300,000 arrived in California in just 5 years.” The influx of population prompted another Yankee mission effort, with 10,000 Yankees arriving over the course of a few years. Still, Yankees succeeded only in establishing a cultural presence on the coast, whereas inland California was populated by a diverse array of peoples from across the world. “The coast blended the moral, intellectual and utopian impulses of a Yankee elite with the self-sufficient individualism of its Appalachian and immigrant majority. The culture that formed – idealistic but individualistic – was unlike that of the gold-digging lands in the interior but very similar to those in western Oregon and Washington. It would take nearly a century for its people to recognize it, but it was a new regional culture, one that would ally with Yankeedom to change the federation.”

Part 4

Part four is titled “Culture Wars”, and takes up a variety of issues from 1878 to 2010.

Chapter 21: Founding the Far West

This chapter argues that the nature of the Western environment blocked grassroots immigration, and instead required large amounts of corporate and/or government infrastructure to make settlement tractable. This, in effect, led to the establishment of corporate colonies, which were primarily focused on extracting resources and exploiting populations, and where the local governments fell under the sway of the corporations or other entities that controlled the local economies. It argues that the legacy of this colonialism, and the continued influence of large corporate entities, is responsible for the Far West’s hostility to government, and to environmental regulation.

“The Far West, uniquely in North America, is a nation defined not by ethnoregional forces but by the demands of external institutions. It is the one place where environment really did trump the cultural heritage of settlers, imposing challenges that Euro-Americans tried to solve through the deployment of capital-intensive technologies: hard rock mines, railroads, telegraphs, Gatling guns, barbed wire, and hydroelectric dams. As a result, the Far West has long been an internal colony of the continent’s older nations and federal government, which possessed the necessary capital. Its people are still often deeply resentful of their dependent status but have generally backed policies guaranteed to preserve the status quo.”

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April 2013

*The Power of Positive Deviance: How Unlikely Innovators Solve the World’s Toughest Problems, R. Pascale, J. Sternin, M. Sternin, Harvard Business Review, 2010.

Key points

“The basic premise is this:
(1) Solutions to seemingly intractable problems already exist,
(2) they have been discovered by members of the community itself,
(3) these innovators (individual positive deviants) have succeeded
even though they share the same constraints and barriers to action.” [p 3-4]

“It is easier to act your way into a new way of thinking than to think yourself into a new way of acting.” That is, once the solution(s) have been discovered, it is not enough to tell others about them; instead, methods must be devised to get participants to practice elements of the solution over significant periods of time, so that they can change their practices.

For this to work, each community must be engaged in the discovery, analysis and enactment processes, and a mechanism for training local facilitators (who in turn train more local facilitators) must be devised.

List of examples in the book

• Planting Gao and Baobab trees that added nitrogen, prevented erosion and provided fruit and firewood. [Poverty and Malnourishment, Sahel Desert, Niger]
  
• Selling Xolair to allergists and pediatricians by teaching them how to administer it via IV and how to deal with insurance issues. [Corporate sales, Genentech]
  
• Serving soup from the bottom of the pot. [Malnourishment]
  
• Adding small shrimp, clams and sweet potato greens to diet; feeding several small meals a day rather than two big ones. [Malnourishment in Vietnam]
  
• Using training to give positive deviants the confidence and skills to speak out against female circumcision. [Public Health, Egypt]
  
• Reducing the rate of MRSA infections via identifying existing practices and discovering new ones [Hospitals in US and Canada]
  
• Increasing sales of Fosamax by discovering the PD sales reps focus on quality rather than quantity in developing/maintaining physician relationships [Corporate sales, Merck Mexico]
  
• Increasing student retention by discovering that PD teachers developed ‘learning contracts’ with each set of parents [Education in Argentina]
  
• Goldman Sachs Private Wealth Management Unit trying to shift from brokerage income to fee-based advice; involved creation of a process very much like PD that doubled productivity over three years.
  
• Reducing incidence of HIC among transvestites by enabling access to trusted and caring health providers rather than by focusing on transvestite-client condom negotiations [Public Health, Jakarta]
  
• Reducing human trafficking in East Java by creating a list of at-risk families and introducing them to PD families. [Public safety]
  
• Reducing unwanted pregnancies among former girl soldiers by identifying systemic practices like a conspiracy to exploit them and lack of (culturally traditional) counseling as problems.
  
• Addressing 8.5% infant mortality among the Pashtun by identifying PD birth practices like placing the infant on a pillow rather than the ground, and use of a clean razor to cut the umbilical cord. [Public Health]
  

Forward, by Atwule Gwande

Excerpts

“First, positive deviants have found ways to resist the tendency built into every financial incentive in our system to see patients as a revenue stream.” [p xiii, 3%]

C1: Against All Odds

Summary. Introduces examples of positive deviance, outlines PD approach, warns that it’s not as simple as it may seem and that understanding and working with social system/local culture is key.

Excerpts

“Positive deviance is founded on the premise that at least one person in a community, working with the same resources as everyone else, has already licked the problem that confounds others. …In most cases, this person does not know he or she is doing anything unusual. Yet once the unique solution is discovered and understood, it can be adopted by the wider community and transform many lives. From the PD perspective, individual difference is regarded as a community resource. Community engagement is essential to discovering noteworthy variants in their midst and adapting their practices and strategies.” [p 3/6%, location 214]

“The basic premise is this: (1) Solutions to seemingly intractable problems already exist, (2) they have been discovered by members of the community itself, (3) these innovators (individual positive deviants) have succeeded even thought they share the same constraints and barriers to action.” [p 3-4]

“[The] distinction between “technical” and “adaptive” work. Adaptive problems are embedded in social complexity, require behavior change, and are rife with unintended consequences. By way of contrast, technical problems (such as the polio virus) can be solved with a technical solution (the Salk vaccine) without having to disturb the underlying social structure, cultural norms, or behavior.” [p 7/8%, location 279]

“The secret sauce of the PD process is how it engages and transforms the social dynamics that have kept things stuck.” [9%, location 340]

C2: Childhood Malnutrition in Vietnam

Summary. The chapter describes an effort – the discovery or ur-instance of the Positive Deviance methodology – to reduce childhood malnutrition in an impoverished area of Vietnam in a relatively short time (6 months). Emphasizes the difficulty (and necessity) of getting the local community involved and getting community members to do the work.

Excerpts

“One of the first steps in the process … has been for the local facilitators to listen to as many people as possible, irrespective of the added value to the listeners learning curve. This engenders the broadest ownership.” [p 32 / 18%, location 658]

“What we needed to do was create an opportunity for people to practice, rather than merely know about, the successful PD behaviors the villagers discovered.” [p 35]

“For two weeks every month, mothers or other caretakers would bring their malnourished children to a neighbor’s house for a few hours every day. Together with the health volunteer, they prepared and fed a nutritious, supplemental meal to their children. … These sessions provided an opportunity to practice successful behaviors identified during the positive deviance inquiry, such as active feeding and washing the caretakers’ and children’s hands with soap and water over the course of the meal whenever they touched an unclear object. …It was the concern for the sustainability of behavioral change that lead to the introduction of the mandatory “daily contribution” component of the nutrition sessions. Every day, each mother or caretaker was required to bring a handful of shrimps, crabs, or greens as the price of admission to the sessions. For two weeks every month, someone in the family (a spouse, an older sibling) had to go out to the rice paddy early in the morning and, ankle deep in mud, collect the required shrimps or crabs. By the time the two week session was over for that month, the trip to the rice paddy with a small net and empty container had become routine.

… “It’s easier to act your way into a new way of thinking, than to think your way into a new way of acting.” [p 37-38]

“Peel the onion and, not surprisingly, the concept harnesses incontrovertible principles of social psychology: Enactment (behaving differently in front of your peers is the shortest distance to thinking differently) and consistency (having staked out a position, we strive to behave accordingly). … Enactment is most effective in shifting a person’s attitudes, self-image, and behavior if involvement is active, public and effortful. [p 46-47]

“From the inside, there is a pressure to bring self-image into line with action. From the outside, there is a social pressure – a tendency to adjust this image according to the way others perceive us. And because others see us a as believing what we have written or said (even when we’ve had little choice in the matter), we experience a pull to bring self-image into line with the written statement.” [p 48]

C3: Female Circumcision in Egypt

Summary. The intractable problem was female circumcision in Egypt. The chapter describes the slow process of finding positive deviants, and the use of workshops to first enable them to share their experiences with one another, and then to train themselves on how to share their experiences with less sympathetic audiences. The process also involved expanding the notion of what a positive deviant was: not just a non-circumcised woman, but others – woman, mothers, Sheiks – who had prevented others from being circumcised.

Excerpts

“You can’t practice not circumcising someone. … Those first volunteers practiced reciting the stories, role-played how they would discuss this sensitive issue with community members, and shared their own stories with one another. They practiced the deviant behavior of speaking out, gaining trust, and breaking a taboo. Once they began speaking with others, the practice of speaking out took on a life of its own and began to spread.” [p 77]

C4: Hospital Infections

Summary. The intractable problem was MRSA, a type of infection that leads to extended hospital stays and fatalities. It can be decreased/eliminated by improving hygienic practices, but that is of course a multi-faced and challenging problem. The chapter describes a campaign to change this. The PD approach needed to be adapted to fit into the pace and structure of hospital life, and to address all categories for workers, from physicians to maintenance. It developed an action-oriented approach called Discovery and Action Dialogs (DADs) which concentrated all phases of PD into brief ~45 minute sessions. DADs lead to the discovery of a large number of solutions, as well as the invention/discovery of new solutions arising out of the increased awareness and understanding of hospital workers. Both the concentrated sessions and the inclusion of discovery (rather than just promotion of endemic solutions) went beyond ‘traditional’ PD. The importance of actually implementing the solutions – and identified the detailed tactics (who will do X, when will they do it, and whose authorization is needed?) – immediately was emphasized.

Excerpts

“Data needs to be dramatized, personified and socialized. … Whether in the form of chocolate pudding, as in the earlier [MRSA] transmission simulation, or macaroni [number of people infected in a year], the community needs a format that brings abstractions to the ground.” [p 98]

* Using PD to increase the rates of student retention in Argentina by discovering that some teachers developed ‘learning contracts’ with each set of parents* [p 94-96]

The PD approach needed to be ‘reformatted’ to work in the context of a hospital. They developed action-oriented Discovery and Action Dialogs [DADs].

“Sessions would kick of with attention getting MRSA transmission statistics. Participants would then try on blood pressure cuffs, remove gloves, and fold gowns, all to reveal how bacteria contaminate a sterile area. Then facilitators, previously self-selected from the ranks, would jump to the crucial question: Is there anyone here who has overcome these challenges?” p 102]

“Staff had seen many hospital campaigns ebb and flow. This time, making change stick could not be left to chance. Accordingly, ideas captured during the DAD sessions needed to be acted upon immediately, and feedback loops confirming results achieved needed to reach every corner of the hospital. Changing the emphasis of the sessions from discover to action had this effect. Facilitators drilled down when ideas surfaced. “Great idea! What would it take to do that in this unit? Is there anyone who wants to volunteer to take those steps? Can you do it alone, or do you need help? is there anyone who needs to be part of that decision who isn’t here in this group now? How do we get her to the table?”
…

“Evidence of action convinced people throughout the hospital that the PD initiative was not business as usual. The news spread rapidly. Elimination of MRSA became prominent in staff awareness. As mindfulness emerged, new solutions began to pop up in likely as well as unlikely places.”[p 103]

This PD process went beyond just discovering existing practices to developing new ones. “But essential aspects of the PS process (the community’s ad individual’s decision to opt in or opt out, taking ownership of the process, investing sweat equity in mapping common practices and outcomes, discovering preexisting Pads, designing an action learning approach to spread discoveries to others) remain intact.” [p 103]

From its beginning in July 2005, the incidence of MRSA at the VAPHS hospital was reduced by 50% in just over a year. Within three years the PD initiative on MRSA had spread to over 40 hospitals and health care centers in the US.

Lessons learned at VAPHS were shared in a 3-day “training of PD facilitators” workshop. New facilitators returned to their sites, ad DAD events were organized – the particular content being decided on individually at each site. DADs were initially applied in beta tests in one or two units of each site, where they were critiqued and refined with the help of external PD trainers.

“It became clear over time that although existing PD practices and new ideas were routinely discovered during the thirty- to forty-minutes DAD sessions, often many were left to wither o the vine. Today facilitators drill down and “capture” a good idea as so as it is discovered and then translate it into action. …This gets into pretty tactical stuff, such as: Who will change the hand-hygiene signs in the room? When will they do it? Whose support or authorization is required?” [p 115]

“Perhaps one of the most striking examples of culture changes at VAPHS … is the shift in power relationships from a few designated leaders in the hospital organization hierarchy to distribution throughout the entire informal network of staff and patients. Shared authority has enabled patients, janitors, and social services assistants to impact MRSA outcomes collectively and exponentially more effectively than a blizzard of top-down reminders from the CDC and the chief surgeon.” [p 117]

Emphasis on the importance of experts [physicians] not be the source of answers.

“I was mortified. Every time I asked a question, if there was a pause of more than five seconds, I stepped in and gave the right answer. I was doing most the talking and putting words into the participants’ mouths.”

… A result of this was the “twenty second deep breath and be silent” mantra.

C5: Early Gains, Squandered Wins: Pioneering the PD Process at Merck

Summary. This chapter looks at two applications of PD in the corporate world: at Merck Mexico, and Goldman Sachs Private Wealth Management Unit. The chapter draws on a mostly implicit model of organizational behavior it refers to as “the standard model.” This envisions corporations as entities that specialize in “process standardization,” and that moreover tend to over-standardize their processes and to “hardwire them” into organizational mechanisms like corporate structure, pricing, key performance indicators, pay for performance, and so on). In this view, a large portion of an organization’s diversity and experimentation happen at the interface between the organization and its customers (often the sales force), but the “Standard Model” is not well geared to ‘listen’ to or learn from these experiments; moreover there is a tendency (“organizational drift”) for the organization’s practices to revert to those that have been standardized.

Merck Mexico was having difficulty selling Fosamax; an article led a Latin American VP to try to apply PD to the process. He presented the idea to his team, and allowed people to opt in or out; most abstained. District managers took it forward, holding focus groups among sales reps, and after a while began hearing repeated mentions of reps who might be PDs. A workshop was convened, and divided into groups of eight reps that were asked to identify the high performing districts and practices that correlated with better results. It became clear that some sales reps were ignoring the rules – e.g., the “Rule of Seven” that mandated seven sales calls a day. Those that made three calls a day were outperforming those that made seven – they were focusing on cultivating relationships with physicians: giving gifts, attending children’s graduation, soliciting ideas for content in Merck-sponsored events. By the end of the year all districts were at quota (from being at 70% of quota), and a year later they were 30% over quota. However, this success did not spread to other drugs or other countries. The story told is that the organizational culture was not friendly to the decentralized PD approach, and that the transfer of supportive high-level executives inhibited the adoption of PD elsewhere, and undermined its continuance in Mexico.

The last part of the chapter looks at an effort to shift Goldman Sachs Wealth Management Unit from a brokerage income model to fee-based advice. The process followed is described at times as PD, although the process was developed in-house. It also strikes me as a bit more top-down than I would expect a PD person to be comfortable with… This part does not provide details on the sorts of changes in practices that positive deviants had developed.

Excerpts

“People in organizations make thousands of decisions, and these sum to define an organization’s trajectory. The arc of these internalized “truths” is invisible but inexorable” How ‘big’ does an opportunity have to be to be ‘interesting’? How are budgets negotiated? … These interpretations reinforce the conventional wisdom about ‘the way things work around here.’ When adaptive change becomes necessary, subtle undercurrents embedded it eh social system can inflict death by a thousand cuts and undermine needed change.” [p 130-131]

“There is a term for the undertow that draws organizations toward traditional patterns. It is called ‘organizational drift,’ and it exercises influence subliminally. Existing political arrangements usually ensure that novel initiatives rarely get a fair day in court.” [p 134-145]

“Albert North Whitehead once said: ‘Civilization advances by extending the umber of operations which we can perform without thinking about them.’” [p 138]

“A bottom up process interjects diversity. The enlarges what we call ‘the solution space.’ Up to a point more diversity means more adaptive capacity. Small and obscure components—easily overlooked—can be ital. … Attention to detail matters and attention to small details matters a lot. I nature, such detail is manifested I gene pools and tiny mutations. Organizational mutations occur among those closest to the action via small adaptations in the face of adversity or opportunity. Those closer to the bottom of the organizational pyramid (for example, in companies where delivery of services or the manufacture of products actually takes place) participate I ‘experiments’ every day. But the standard model isn’t especially well geared to listening, let alone learning through this bottom up channel. [p 141-142]

“The biggest limitation of the standard model is that it takes process standardization too far. It losses its potency when local knowledge and aesthetic judgment matter.” [p 142]

Goldman Sachs example – not much detail offered. [p 142-146]

C6: Girl Soldiers in Uganda

Summary. Discusses a mid-course correction of a not-very-well-applied PD approach in Uganda. The original team had identified exceptional cases as per orthodox PD, but had then collapsed the distinct steps of the PD Process (i.e. engage the community, define the problem, establish baseline conditions, document common practices, and discover PD strategies) into one, and were using experts(NGO trainers) and not the community or repatriated girls themselves to present the workshops that disseminated the solutions. The mid-course correction involved addressing three issues: reframing problems; facilitating group discussions to mobilize action; ensuring that the community does the work.

Excerpts

“The initial framing of the problem often turns out to be a placeholder. If experience teaches one lesson, it is that problem reframing usually occurs along the way. The surest way for a community to recognize a problem as its own is for people to frame it in their own words and ground it in their own reality. Stakeholders need to imprint on a problem…” [p 155]

“The term ‘group conversations’ is ear the opposite end of a continuum [from focus groups]. The term group conversations is chosen to signal that something very different is required. Certain kids of questions help groups take ownership. Questions can be more transforming than answers. Powerful questions don’t dig for information, but instead cause respondents to think. They evoke a choice for commitment and accountability.” [p 161]

“In the PD process, the real objective [of group conversations] … is engagement, creating a buzz, mobilizing people to take action.”

Example of discovery of two problems — conspiracy to exploit girls and lack of (culturally traditional) counseling by ‘grandmothers’ — in group conversations. [p 165-167]

C7: Infant Mortality

Summary. Aim was to reduce 8.5% infant mortality rate among the Pashtun. Initially created discussion groups of men, who used colored pebbles and paper to create map of village and various birth outcomes at various houses. After a few weeks the men decided there should be a woman’s group, and so one was created and they used beans to develop a map. After this, groups went to visit various households, and began identifying PD practices. Examples included laying the infant on a pillow rather than the ground, use of a clean razor to cut the umbilical cord, and providing honey rather than breast milk for first few days of infant’s life. To disseminate the findings the women’s team employed a grab bag where they pulled out items (e.g. a pillow) and had to explain its use; similarly, the men’s team created a bazaar, where the audience selected things to buy and then had to provide a rationale. They also showed a simulation of putting ink on a knife blade and slicing an onion, to communicate transfer of infections…. After the workshops, volunteers gathered to develop a strategy for enabling the community to put the solutions into practice and to continue learning – this involved the men meeting once a month at a tea shop to discuss recent newborns, new practices, etc. The chapter claims that as a result of PD husbands and wives began communicating more, initially about the birthing practices, and then gradually about broader matters.

Excerpts

“Dissemination workshops tended to follow a trajectory. They led off with an introduction of technical PD practices (e.g., clean razor blades) but turned inevitably to the importance of the husband’s involvement and support of his wife.” [p 178]

C8: Nature’s Way

Excerpts

“Positive deviance modularizes in two important respects. First it narrowly focuses on the specific itch the community wants to scratch. … Second, each social entity is a module in its own right. Solutions are never exported wholesale.” [p 187]

Summary. The final chapter reflects on the success of the PD approach. It draws a parallel to evolution, with PD depicted as a way to identify and propagate useful adaptations that are always occurring in social systems. The PD process begins by looking for the parts of a social system that are experiencing perturbation and thus undergoing adaptation (or carrying out experiments). It then invites participation from members of the social system and provides a self-generated scaffolding that allows those members to identify the successful experiments and the mechanisms behind the success – this often involves reframing the initial problem as well. Finally, the participants figure out how to operationalize the solutions – and sometimes, when rapid proof of efficacy is required as in the hospital example this must happen right away – and ensure that the social system continues to learn to address the problem ever more effectively.

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Appendix: Basic Field Guide to the Positive Deviance Approach

Summary. Provides a synopsis of and guide to the PD Approach. Includes tips for facilitators, examples of productive questions that can be posed, and the four steps of the PD Process: 1) Community defines or re-frames the problem; 2) Community discovers common practices; 3) Community discovers presence of positive deviants; 4) Community designs and develops activities to support and expand the PD solutions.

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